Getting Out From Under Chronic Pain

Chronic Pain is exactly that—chronic. It’s pain that doesn’t go away. Pain you live with day in and day out regardless of your plans and schedule. It can hijack your life, leaving you feeling out of control and, often, depressed and anxious. It comes in all shapes and sizes—back pain, neck pain, knee or hip pain. Fibromyalgia. Arthritis. Migraine. Autoimmune diseases. Regardless of the source, chronic pain can take our joy and our control. It can hurt our relationships with others who may not understand chronic pain or who are weary of its impact too. We have medicine, but it doesn’t always work and doctors are understandably concerned about over-prescribing. Yet where does that leave you? With chronic pain. Everyday. It often feels overwhelming.

It doesn’t have to be. Chronic pain therapy is an excellent add-on to medication (or, in some situations, a substitute for medication). It focuses on behaviors you can learn to help you manage your pain on a daily basis and take back some of the control that chronic pain has taken away. 

“I FEEL SO ALONE WITH MY PAIN”…

It’s understandable you may feel alone and isolated with your pain. It keeps us from going out and takes away our ability to engage in spur-of-the-moment fun. Sometimes others move on without us, leaving us behind and feeling lonely. However, you are not alone. In fact, more than 25 million American adults suffer with daily chronic pain, and another 23 million report being in “a lot of pain” per a study in The Journal of Pain in 2015.* Almost fifty million people in the U.S. alone suffer with pain! If you are one of them, don’t you owe it to yourself to begin to feel better?
*Nahin, R.L. (2015). Estimates of Pain Prevalence and Severity in Adults: United States, 2012. The Journal of Pain, 16, 8, 769-780.

WHAT DOES CHRONIC PAIN THERAPY INCLUDE?

Chronic pain therapy focuses on two areas: 1) Skills for coping with chronic pain; and 2) Skills/therapy addressing mood related to chronic pain. 

Skills for coping with chronic pain: It can come as a happy surprise that tools exist for coping with chronic pain beyond medication. These natural approaches to pain management can be used with or without medicine as a means of limiting, relieving, and coping with pain. 

• Relaxation—Several skills exist that are helpful for increasing relaxation and decreasing muscle tension. These include Progressive Muscle Relaxation (PMR), Body-Scanning, and gentle muscle stretching among others.

• Distraction—When pain is flaring, distraction can help you get through the pain. We will discuss a variety of skills designed to distract you from the pain and identify the ones that work best for you.

• Sleep—By evaluating and making behavioral changes to improve your sleep, you’ll have more energy and less irritability, both of which can help you to better manage chronic pain.

• Time Management—How often have you had a “good day” in regard to your pain and decided to go “full out” to get tasks done only to pay for it the next day? In chronic pain therapy, we’ll talk about some ways to get more done without risking a bad pain flare.

Of equal importance is addressing your mood, which is often impacted by chronic pain. Several skills focus on understanding the relationship between mind and body and help to improve mood. By coping with the emotional impact of pain, your physical pain will also likely decrease because emotional pain adds stress, and stress adds physical pain.

• Stress Management—Why is managing stress important? Well, when our stress level is high, our chronic pain tends to flare. This can happen for a variety of reasons: muscle tension goes up, sleep suffers, and stress hormones increase, to name a few. Importantly, this is not to say that stress causes chronic pain but that it can definitely make it worse. By teaching you to keep your stress level low you’ll be better able to cope and decrease chronic pain.

• Cognitive Behavioral Therapy (CBT) for pain management explores our thoughts and beliefs about ourselves, our chronic pain, other people, and the world we live in, and helps find patterns of thinking that may interfere with the quality of life. By identifying beliefs that are problematic, particularly in regard to chronic pain, we can begin to change how you choose to think so it is more accurate and helpful in daily life. CBT also focuses on changing behaviors and building helpful skills.  My initial training as a therapist was in CBT and I have used CBT and CBT-related therapies for almost 20 years. 

• Acceptance and Commitment Therapy (ACT) shares elements of cognitive behavioral therapy while also adding the importance of mindfulness (being present in the moment, and aware and accepting of your feelings, thoughts and body sensations). In addition, ACT explores your personal values in life, and helps you to move toward those values.  In regard to chronic pain therapy, ACT can help you make choices that are in line with what is most important to you. For instance, if attending your child or grandchild’s baseball game is something you feel strongly about, then let’s figure out what is going to help get you to that game. What do we need to do to prepare for pain during the game? What do we need to make sure you’re doing (and NOT doing!) before the game? How should you take care of yourself after the game? By identifying and working toward goals that align with their values, folks generally feel happier and more satisfied with life. I have used ACT with individuals and in groups for several years. 

• Mindfulness—as noted above, mindfulness can be part of a larger treatment approach in chronic pain therapy. It can also be used alone as a helpful means of staying aware of yourself in the moment, and accepting of your feelings, your thoughts, and body sensations. This is important because often we try to push aside our chronic pain, thinking that if we ignore the physical and emotional pain it will go away. The reality is this can actually lead to worse pain. Mindfulness can teach us the value of awareness in developing helpful responses to cope with pain. 

In chronic pain therapy we will find the best technique or combination of techniques that will allow you to re-engage with life. I’ve worked with patients to help them manage their chronic pain for almost 20 years. I understand chronic pain, and the loneliness and disappointment it causes. You will have my strong commitment toward helping you feel better. With a strong commitment from you, we can get you feeling better and more in control of your life. 

SOME COMMON QUESTIONS ABOUT CHRONIC PAIN THERAPY…

You may have some concerns about starting chronic pain therapy. Here are some answers to common questions about this treatment:

How long does chronic pain therapy usually take?
Chronic pain therapy includes learning, practicing and applying new skills to your daily life. Learning these skills can take as little as 2-4 sessions. Being diligent about practicing them at home and applying them in daily life is up to each client. The more dedicated you are, the faster your confidence and skill level will grow. Learning to cope with the emotional part of pain is a longer process, typically 6-8 sessions. We will work on both sets of skills at the same time. Clients can generally expect to spend 8-12 sessions in chronic pain therapy with booster sessions as needed. 

You say that the client has to be diligent—I’m so exhausted by my pain I don’t know if it’s even possible for me to engage in chronic pain therapy.
I absolutely understand the concern. We will start therapy exploring your pain and understanding where we can make the greatest improvement most quickly. And, honestly, most of these techniques feel pretty good—that’s why they work! The commitment comes in with taking the time to practice these feel-good skills daily and looking for ways to add the skills to your life. Practicing the skills and managing your pain pays off in more quality time, more energy, and less pain.

How do I pick a therapist for chronic pain therapy?
Picking a therapist is usually about the match of therapy style, experience, and abilities of the therapist with your personal preferences.  I provide therapy in a warm, compassionate environment that is free of judgment. I’m going to gently encourage you to make progress and if you feel stuck we’ll work together to get you moving again. In terms of experience and training, I have a Ph.D. in clinical psychology and did postdoctoral training in the connection between stress and health. I’ve worked for almost 20 years as a therapist, including several years as a therapist for National Institutes of Health (NIH) studies exploring best treatments for the chronic pain of fibromyalgia and migraine headache. I have worked as the health psychologist and the Health Behavior Coordinator for the Washington DC VA Medical Center.  My duties included group and individual therapy for patients coping with chronic pain. I understand chronic pain and its impact on your life and I have the experience and knowledge to treat this pain effectively.  Let’s work together to help you feel better! 

If you would like to schedule a free 30-minute consultation or discuss any questions you may have about chronic pain therapy, please call me, Dr. Jana Drew, at 512-960-5265 or contact me here.